title: Evaluation of a phosphate management protocol to achieve optimum serum phosphate levels in hemodialysis patients.
abstract: OBJECTIVE
  To evaluate the effectiveness of a protocol designed to optimize serum phosphate levels in patients undergoing regular hemodialysis (HD).
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Hemodialysis units at Barts and the London NHS Trust and satellite units.
  
  
  METHODS
  Thirty-four clinically stable adults undergoing regular HD with a serum phosphate level >1.8 mmol/L on at least one occasion within 4 months of starting the study.
  
  
  METHODS
  Management of serum phosphate using a specially designed phosphate management protocol during a 4-month study period implemented by a renal dietitian and renal pharmacist compared with standard practice.
  
  
  METHODS
  Change in serum phosphate levels in both groups after 4 months.
  
  
  RESULTS
  Patients managed using the phosphate management protocol had a significantly greater reduction in serum phosphate levels compared with patients receiving standard practice (-0.22 +/- 0.67 mmol/L vs. +0.19 +/- 0.32 mmol/L, P = 0.03).
  
  
  CONCLUSIONS
  The phosphate management protocol was effective, and its implementation was associated with significantly better serum phosphate control in patients undergoing regular HD.
authors.affiliation: Department of Health and Human Sciences, Barts and the London NHS Trust, London Metropolitan University, London, UK.
authors.forename: Dawn
authors.initials: D
authors.lastname: Yokum
authors.forename: Georgina
authors.initials: G
authors.lastname: Glass
authors.forename: Ching Fun
authors.initials: CF
authors.lastname: Cheung
authors.forename: John
authors.initials: J
authors.lastname: Cunningham
authors.forename: Stanley
authors.initials: S
authors.lastname: Fan
authors.forename: Angela M
authors.initials: AM
authors.lastname: Madden
mesh_terms: D002118:Calcium / Q000097:blood / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D010353:Patient Education as Topic; D010358:Patient Participation; D028044:Phosphate-Binding Proteins / Q000494:pharmacology*; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood / Q000378:metabolism
chemical_list: D010281:Parathyroid Hormone; D028044:Phosphate-Binding Proteins; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium